Nevertheless, Russell and Whitehead had discovered something important: that most mathematics – if not all of it – could be derived from a number of axioms logically related to each other. This boost for mathematical logic may have been their most important legacy, inspiring such figures as Alan Turing and John von Neumann, mathematicians who in the 1930s and 1940s conceived the early computers. It is in this sense that Russell and Whitehead are the grandfathers of software.60
In 1905 in the British medical periodical the Lancet, E. H. Starling, professor of physiology at University College, London, introduced a new word into the medical vocabulary, one that would completely change the way we think about our bodies. That word was hormone. Professor Starling was only one of many doctors then interested in a new branch of medicine concerned with ‘messenger substances.’ Doctors had been observing these substances for decades, and countless experiments had confirmed that although the body’s ductless glands – the thyroid in the front of the neck, the pituitary at the base of the brain, and the adrenals in the lower back – manufactured their own juices, they had no apparent means to transport these substances to other parts of the body. Only gradually did the physiology become clear. For example, at Guy’s Hospital in London in 1855, Thomas Addison observed that patients who died of a wasting illness now known as Addison’s Disease had adrenal glands that were diseased or had been destroyed.61 Later Daniel Vulpian, a Frenchman, discovered that the central section of the adrenal gland stained a particular colour when iodine or ferric chloride was injected into it; and he also showed that a substance that produced the same colour reaction was present in blood that drained away from the gland. Later still, in 1890, two doctors from Lisbon had the ostensibly brutal idea of placing half of a sheep’s thyroid gland under the skin of a woman whose own gland was deficient. They found that her condition improved rapidly. Reading the Lisbon report, a British physician in Newcastle-upon-Tyne, George Murray, noticed that the woman began her improvement as early as the day after the operation and concluded that this was too soon for blood vessels to have grown, connecting the transplanted gland. Murray therefore concluded that the substance secreted by the gland must have been absorbed directly into the patient’s bloodstream. Preparing a solution by crushing the gland, he found that it worked almost as well as the sheep’s thyroid for people suffering from thyroid deficiency.62
The evidence suggested that messenger substances were being secreted by the body’s ductless glands. Various laboratories, including the Pasteur Institute in New York and the medical school of University College in London, began experimenting with extracts from glands. The most important of these trials was conducted by George Oliver and E. A. Sharpy-Shafer at University College, London, in 1895, during which they found that the ‘juice’ obtained by crushing adrenal glands made blood pressure go up. Since patients suffering from Addison’s disease were prone to have low blood pressure, this confirmed a link between the gland and the heart. This messenger substance was named adrenaline. John Abel, at Johns Hopkins University in Baltimore, was the first person to identify its chemical structure. He announced his breakthrough in June 1903 in a two-page article in the American Journal of Physiology. The chemistry of adrenaline was surprisingly straightforward; hence the brevity of the article. It comprised only a small number of molecules, each consisting of just twenty-two atoms.63 It took a while for the way adrenaline worked to be fully understood and for the correct dosages for patients to be worked out. But adrenaline’s discovery came not a moment too soon. As the century wore on, and thanks to the stresses of modern life, more and more people became prone to heart disease and blood pressure problems.
At the beginning of the twentieth century people’s health was still dominated by a ‘savage trinity’ of diseases that disfigured the developed world: tuberculosis, alcoholism, and syphilis, all of which proved intractable to treatment for many years. TB lent itself to drama and fiction. It afflicted the young as well as the old, the well-off and the poor, and it was for the most part a slow, lingering death – as consumption it features in La Bohème, Death in Venice, and The Magic Mountain. Anton Chekhov, Katherine Mansfield, and Franz Kafka all died of the disease. Alcoholism and syphilis posed acute problems because they were not simply constellations of symptoms to be treated but the charged centre of conflicting beliefs, attitudes, and myths that had as much to do with morals as medicine. Syphilis, in particular, was caught in this moral maze.64
The fear and moral disapproval surrounding syphilis a century ago mingled so much that despite the extent of the problem, it was scarcely talked about. Writing in the Journal of the American Medical Association in October 1906, for example, one author expressed the view that ‘it is a greater violation of the proprieties of public life publicly to mention venereal disease than privately to contract it.’65 In the same year, when Edward Bok, editor of the Ladies’ Journal, published a series of articles on venereal diseases, the magazine’s circulation slumped overnight by 75,000. Dentists were sometimes blamed for spreading the disease, as was the barber’s razor and wet nurses. Some argued it had been brought back from the newly discovered Americas in the sixteenth century; in France a strong strand of anticlericalism blamed ‘holy water.’66 Prostitution didn’t help keep track of the disease either, nor Victorian medical ethics that prevented doctors from telling one fiancée anything about the other’s infections unless the sufferer allowed it. On top of it all, no one knew whether syphilis was hereditary or congenital. Warnings about syphilis sometimes verged on the hysterical. Vénus, a ‘physiological novel,’ appeared in 1901, the same year as a play called Les Avariés (The Rotting or Damaged Ones), by Eugène Brieux, a well-known playwright.67 Each night, before the curtain went up at the Théâtre Antoine in Paris, the stage manager addressed the audience: ‘Ladies and Gentlemen, the author and director are pleased to inform you that this play is a study of the relationship between syphilis and marriage. It contains no cause for scandal, no unpleasant scenes, not a single obscene word, and it can be understood by all, if we acknowledge that women need have absolutely no need to be foolish and ignorant in order to be virtuous.’68 Nonetheless, Les Avariés was quickly banned by the censor, causing dismay and amazement in the editorials of medical journals, which complained that blatantly licentious plays were being shown in café concerts all across Paris with ‘complete impunity’.69
Following the first international conference for the prevention of syphilis and venereal diseases in Brussels in 1899, Dr Alfred Fournier established the medical speciality of syphilology, using epidemiological and statistical techniques to underline the fact that the disease affected not just the demimonde but all levels of society, that women caught it earlier than men, and that it was ‘overwhelming’ among girls whose poor background had forced them into prostitution. As a result of Fournier’s work, journals were established that specialised in syphilis, and this paved the way for clinical research, which before long produced results. On 3 March 1905 in Berlin, Fritz Schaudinn, a zoologist, noticed under the microscope ‘a very small spirochaete, mobile and very difficult to study’ in a blood sample taken from a syphilitic. A week later Schaudinn and Eric Achille Hoffmann, a bacteriologist, observed the same spirochaete in samples taken from different parts of the body of a patient who only later developed roseolae, the purple patches that disfigure the skin of syphilitics.70 Difficult as it was to study, because it was so small, the spirochaete was clearly the syphilis microbe, and it was labelled Treponema (it resembled a twisted thread) pallidum (a reference to its pale colour). The invention of the ultramicroscope in 1906 meant that the spirochaete was now easier to experiment on than Schaudinn had predicted, and before the year was out a diagnostic staining test had been identified by August Wassermann. This meant that syphilis could now be identified early, which helped prevent its spread. But a cure was still needed.71